Goldman Ran D, Amin Parsa, Macpherson Alison
Pediatric Research in Emergency Therapeutics ( Program, Division of Pediatric Emergency Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada.
Pediatr Emerg Care. 2006 Sep;22(9):640-3. doi: 10.1097/01.pec.0000227865.38815.ec.
Quality and accessibility of care for patients presenting to the emergency department (ED) can be limited if they cannot communicate in the same language as their health care provider.
We aimed to determine if children whose parents speak a primary language other than English have a longer length of stay (LOS) in the ED compared with English-speaking families.
We reviewed computerized ED records of age-matched English and 4 most common non-English languages in a tertiary pediatric hospital in Toronto, Canada. We randomly chose English-speaking families in a 3:1 ratio with non-English. We performed bivariate analyses and a multivariable linear regression to test the relationship between language, triage score, age, gender, day of the week, and diagnostic grouping.
Out of 48,497 visits for 1 year, we included 6051 English-, 628 Spanish-, 486 Cantonese-, 486 Mandarin-, and 417 Tamil-speaking families. The average LOS was 3.86 and 3.95 hours for English and non-English-speaking patients, respectively (P > 0.05). Non-English speakers had lower acuity more frequently (P = 0.004) and arrived more over weekdays (P = 0.02). In the multivariate regression model, language, triage score, age, and gender were all significantly associated with LOS. Only 6% of the variance in LOS was explained by the regression model.
Language, triage score, patient age, and gender are significantly associated with LOS in the ED. Among other interventions, securing ways to accommodate non-English-speaking health providers in the ED can possibly shorten the LOS and reduce nonacute visits to the ED.
如果患者不能使用与医护人员相同的语言进行交流，那么前往急诊科（ED）就诊的患者所接受的医疗服务质量和可及性可能会受到限制。
我们旨在确定父母母语非英语的儿童与说英语的家庭相比，在急诊科的住院时间（LOS）是否更长。
我们回顾了加拿大多伦多一家三级儿科医院中年龄匹配的英语及4种最常见非英语语言患者的电子急诊记录。我们以3:1的比例随机选择说英语的家庭与非英语家庭。我们进行了双变量分析和多变量线性回归，以检验语言、分诊评分、年龄、性别、星期几和诊断分组之间的关系。
在一年的48497次就诊中，我们纳入了6051个说英语、628个说西班牙语、486个说粤语、486个说普通话和417个说泰米尔语的家庭。说英语和非英语患者的平均住院时间分别为3.86小时和3.95小时（P>0.05）。非英语使用者 acuity较低的情况更常见（P = 0.004），且在工作日就诊的更多（P = 0.02）。在多变量回归模型中，语言、分诊评分、年龄和性别均与住院时间显著相关。回归模型仅解释了住院时间6%的方差。
语言、分诊评分、患者年龄和性别与急诊科的住院时间显著相关。在其他干预措施中，确保在急诊科为非英语医护人员提供便利的方式可能会缩短住院时间并减少非急症患者前往急诊科就诊的次数。
